Deck 16: Care of the Patient with HIV/AIDS

Question 1

A male patient is concerned about telling others he has HIV infection.What should the nurse stress when discussing his concerns?

A) Care providers and sexual partners should be told about his diagnosis.
B) There is no reason to hide his disease.
C) Secrecy is a poor idea because it will lower his self-esteem.
D) His diagnosis will be obvious to most people with whom he will come into contact.

Answer 1

Care providers and sexual partners should be told about his diagnosis.

Question 2

Why should interventions such as promotion of nutrition,exercise,and stress reduction be undertaken by the nurse for patients who have HIV infection?

A) They will promote a feeling of well-being in the patient.
B) They will improve immune function.
C) They will prevent transmission of the virus to others.
D) They will increase the patient's strength and ability to care for himself or herself.

Answer 2

They will improve immune function.

Question 3

To be diagnosed as having AIDS,the patient must be HIV-positive,have a compromised immune system without known immune system disease or recent organ transplant,and present with which of the following?

A) Opportunistic infection
B) A positive ELISA or Western blot test
C) Weight loss,fever,and generalized lymphedema
D) CD4+ lymphocyte count less than 200 mm3

Answer 3

CD4+ lymphocyte count less than 200 mm3

Question 4

A 21-year-old male who has been an IV heroin user has been experiencing fever,weight loss,and diarrhea and has been diagnosed as having AIDS.At this time,he has a low-grade fever,severe diarrhea,and a productive cough.He is admitted with Pneumocystis jiroveci.What should the nurse do when caring for the patient?

A) Use a gown,mask,and gloves when assisting the patient with his bath
B) Wear a gown when assisting the patient to use the bedpan
C) Use a gown,mask,and gloves to administer oral medications
D) Use a mask when taking the patient's temperature

Question 5

The HIV patient asks the nurse about what to expect in terms of disease progression.The nurse tells this patient that although the disease can vary greatly among individuals,the usual pattern of progression includes:

A) viremia,clinical latency,opportunistic diseases,and death.
B) asymptomatic phase,clinical latency,ARC,and AIDS.
C) acute retroviral syndrome,early infection,early symptomatic disease,and AIDS.
D) transitional viral syndrome,inactive disease,early symptomatic infection,and opportunistic diseases.

Question 6

A young gay patient being treated for his third sexually transmitted disease does not see why he should use condoms,because "they don't work." Which is the most appropriate response?

A) "Condoms may not provide 100% protection,but when used correctly and consistently with every act of sexual intercourse they reduce your risk of getting infected with HIV or other sexually transmitted diseases."
B) "You are correct.Condoms don't always work,so your best protection is to limit your number of partners."
C) "Condoms do not provide 100% protection,so you should always discuss with your sexual partners their HIV status or ask if they have any STD."
D) "Condoms do not provide 100% protection,but when used with a spermicide you can be assured of complete protection against HIV and other STDs."

Question 7

What do the activated monocytes and macrophages produce in the presence of an inflammatory process?

A) Reduction of red cells
B) Increase in WBCs
C) Neopterin
D) Increase in T-helper cells increase natural killer (NK)cells

Question 8

The anxious male patient is fearful that he has been exposed to a person with an HIV infection.He states he does not want to go to a laboratory for the ELISA tests because he does not want to be identified.What would be the nurse's most helpful response?

A) "There really is not an option,you will need to get the Western blot test first."
B) "There is an FDA-approved home test called OraQuick."
C) "The rapid test Reveal can identify all the HIV strains."
D) "You can be tested anonymously for ELISA.If you are seronegative,your concerns are over."

Question 9

What should the nurse emphasize when counseling an anxious HIV-positive mother about the care of her HIV-positive infant?

A) The baby will develop AIDS and refer her to a local AIDS support group.The baby will remain HIV-positive for the rest of its life.
B) Although infants of HIV-infected mothers may test positive for HIV antibodies,not all infants are infected with the virus.
C) She has not yet developed AIDS,and that it is possible the baby will not develop AIDS for many years.
D) If the infant is started on zidovudine (AZT)within the first month after delivery,AIDS can be prevented.

Question 10

A 28-year-old married attorney with one child is in the first trimester of her second pregnancy.The patient states that she is at no risk for HIV,so she would not need to be counseled about testing for HIV.Which is the most appropriate response?

A) "She's a professional woman in a monogamous relationship.She obviously is not at risk."
B) "Women are not at great risk.The greatest risk is with gay men."
C) "The fastest-growing segment of the population with AIDS is women and children.We need to assess her risks."
D) "We need to review her chart to determine if her first child was infected."

Question 11

For most people who are HIV-positive,marker antibodies are usually present 10 to 12 weeks after exposure.What is the development of these antibodies called?

A) Immunocompetence
B) Seroconversion
C) Opportunistic infection
D) Immunodeficiency

Question 12

The patient,age 21,has been treated for chlamydia and has a history of recurrent herpes.What should the nurse counsel this patient about?

A) Sexual history,risk reduction measures,and testing for HIV
B) Getting an appointment at a family planning clinic
C) Testing for HIV and what the test results mean
D) Abstinence and a monogamous relationship

Question 13

A male patient is advised to receive HIV antibody testing because of his multiple sexual partners and injectable drug use.What should the nurse inform the patient to ensure understanding?

A) The blood is tested with the highly sensitive test called the Western blot.
B) The blood is tested with an ELISA;if positive,it is tested again with an ELISA,followed by a Western blot if the second ELISA is positive.
C) A series of HIV tests is performed to confirm if the patient has AIDS.
D) If the HIV tests are seronegative,the patient can be assured that he is not infected.

Question 14

A patient has just been diagnosed as HIV-positive.He asks the nurse,"Does this mean I have AIDS?" Which response would be most informative?

A) "Most people get AIDS within 3 to 12 weeks after they are infected with HIV."
B) "Don't worry.You may never get AIDS if you eat properly,exercise,and get plenty of rest."
C) "It varies with every individual,but the average time is 8 to 10 years from the time a person is infected,and some go much longer."
D) "You can expect to develop signs and symptoms of AIDS within 6 months."

Question 15

Which of the following is a CDC criterion for the progression of HIV infection to AIDS?

A) Increase in viral load
B) Decreased ratio of CD8 to CD4
C) Increase in white blood cells
D) Increased reactivity to skin tests

Question 16

When assigned to a newly admitted patient with AIDS,the nurse says,"I'm pregnant.It is not safe for me or my baby if I am assigned to his case." Which is the most appropriate response by the charge nurse?

A) "This patient would not be a risk for your baby if you use standard precautions and avoid direct contact with blood or body fluids."
B) "You should ask for a transfer to another unit because contact with this patient would put you and your baby at risk for AIDS."
C) "Wear a mask,gown,and gloves every time you go into his room and use disposable trays,plates,and utensils to serve his meals."
D) "We should recommend that this patient be transferred to an isolation unit."

Question 17

What should the nurse look for when reviewing a patient's chart to determine whether she has progressed from HIV disease to AIDS?

A) CD4+ count below 500,chronic fatigue,night sweats
B) HIV-positive test result,CD4+ count below 200,history of opportunistic disease
C) Weight loss,persistent generalized lymphadenopathy,chronic diarrhea
D) Fever,chills,CD4+ count below 200

Question 18

The nurse should instruct the patient who is diagnosed with AIDS to report signs of Kaposi sarcoma,which include:

A) Reddish-purple skin lesions
B) Open,bleeding skin lesions
C) Blood-tinged sputum
D) Watery diarrhea

Question 19

While teaching community groups about AIDS,what should the nurse indicate as the most common method of transmission of the HIV virus?

A) Sexual contact with an HIV-infected partner
B) Perinatal transmission
C) Exposure to contaminated blood
D) Nonsexual exposure to saliva and tears

Question 20

A patient states that he feels terrific,but a blood test shows that he is HIV-positive.It is important for the nurse to discuss with him that HIV may remain dormant for several years.What is true of the patient during this time?

A) He is not dangerous to anyone.
B) He experiences minor symptoms only.
C) He experiences decreased immunity.
D) He is contagious.

Question 21

What medication times should the nurse use in writing out a schedule for taking antiretroviral medication three times a day?

A) 8 AM - 2 PM - 8 PM
B) 8AM - 4PM - 12 AM
C) 8AM - 5PM - 1 AM
D) Be given with meals

Question 22

Which foods would a nurse recommend for a person with debilitating diarrhea as a result of HIV infection? (Select all that apply. )

A) Bananas
B) Ensure
C) Fresh broccoli
D) Cooked fruits and vegetables
E) Red meat
F) Apricot nectar

Question 23

The term that describes an immunosuppressed patient's inability to react to a skin test is __________________.

Question 24

The historical progress of the HIV infection began to be tracked in 1979.Arrange the historical events in sequence of their discovery.(Separate letters by a comma and space as follows: A,B,C,D)

A) Infection in heterosexual men and women
B) Infection in hemophiliacs
C) Infection in injection drug users
D) Increased incidence of Kaposi carcinoma in young homosexual men
E) Increased incidence of Pneumocystis jiroveci (previously PCP)

Question 25

Which of the following are examples of the AIDS wasting syndrome in a patient with an HIV infection? (Select all that apply. )

A) Episodes of vomiting for 20 days
B) Appearance of Kaposi sarcoma
C) Loss of 10% of body mass
D) Marked hair loss
E) Episodes of diarrhea for 30 days
F) Episodes of hypotension

Question 26

Which of the following are methods in which children with AIDS could have contracted their disease? (Select all that apply. )

A) During intrauterine life with an HIV-positive mother
B) During the birth process of an HIV-positive mother
C) From other children who are HIV positive
D) From receiving a transfusion contaminated with the HIV virus
E) From breastfeeding by an HIV-positive mother

Question 27

After what period of time would the home health nurse make a mental health appointment for a patient with an HIV infection after assessing a diminished ability to attend to daily functioning?

A) 1 week
B) 2 weeks
C) 3 weeks
D) 1 month

Question 28

The home health nurse designing a teaching plan for a person with HIV disease that would support weight gain would include information pertaining to (Select all that apply. )

A) Limit fluid intake
B) Eating high-protein/high-calorie diet
C) Drinking nutritional supplements (Boost,Sustacal,etc. )
D) Eating several small meals during the day
E) Providing referrals to dietitians
F) Resistance weight training

Question 29

Why are snacks high in potassium,such as bananas and apricot nectar,recommended?

A) Electrolytes are lost through diaphoresis.
B) Sodium is lost through frequent diarrhea.
C) Potassium will support weight gain.
D) Potassium helps fight infection.

Question 30

The depressed patient with AIDS says,"I don't understand why I am going to be getting doses of testosterone.What good will that do me now?" What should the nurse keep in mind about testosterone when responding?

A) It can lower viral load
B) It can lighten depression
C) It can increase lean body mass
D) It can increase appetite

Question 31

The combination of efforts of the medical team,nutritionist,social workers,and clergy is the necessary ______________ approach to the complex needs of the patients with HIV infection.

Question 32

Which of the following are early signs and symptoms of an HIV infection? (Select all that apply. )

A) Dry mouth
B) Weight loss
C) Sore throat
D) Vaginal dryness
E) Nausea

Question 33

How does the HIV-2 virus compare to the HIV-1 virus? (Select all that apply. )

A) It has lower mortality risks in the older adult
B) It is less virulent
C) It is less infectious in the initial stage of infection
D) It predisposes the HIV-infected person to a normal life span
E) It develops high viral loads

Question 34

______________ is a type of sexual option classified as "no risk" for a person to become infected with the HIV virus.

Question 35

The HIV-infected patient who has just seroconverted says he just cannot take all those confusing,expensive antiretroviral (ART)medications.He says he still feels fine,anyway.What should the nurse keep in mind when counseling this patient?

A) Resumption of the ART later in the disease is just as effective
B) Adherence to the ART protocol is essential to the success of the treatment
C) Cessation of the ART may prevent the emergence of a resistant strain of HIV
D) Once ART is initiated it cannot be restarted in the same patient

Question 36

An organism that can cross from an animal species to humans is a(n)____________organism.

Question 37

The nurse explains that an enzyme ____________ ____________ allows the RNA of the retrovirus to be changed to DNA and incorporated into the host's genetic material.